1.) What were your first steps when beginning this analysis?
One of the recommendations of the Colorado Strategic Action Plan on Aging was to create a more robust data set with information about older adults to better identify opportunities for improvement across the lifespan. Especially information about adults over 65 and broken out by age bracket (60-64, 65-69, 70-74, 75-79, 80-84, 85+). Other states have built similar Healthy Aging Data Reports and created over 100 measures to support their work.
2.) Were there specific considerations you needed to consider based on the data?
When we began, we knew that we had to be selective as to which data points we would develop based on what is available through the Colorado All Payer Claims Database (CO APCD). Not all measures included in the other state Aging Profiles are available with claims data such as the number of grandparents living with grandchildren, the percentage of those over 60 who own a car, or the household income and availability of community services (i.e., # of libraries, senior centers, etc.). Eventually, we narrowed it down to 15 measures for the first phase of the project.
3.) What challenges did you encounter while performing the analysis? How did you overcome them?
We had to make sure that our measures could answer our questions. Fortunately, we had expertise on our team and worked closely with the experts like Jarett Hughes, Deputy Director of Policy and Research in the Governor’s office and Erica Felder, in the CO Department of Human Services. Having strong partnerships and open communication helped us work seamlessly to ensure we developed measures that were accurate and could answer questions that we had.
4.) Without delving into results, did anything surprise you about this analysis or the process of executing it?
The CO APCD is a very robust dataset, which means there is a lot of data and it tends to be complex. One of the measures was related to those utilizing Long-Term Services and Support (LTSS) Waivers. Waivers are supplemental benefits for Medicaid recipients, and while CIVHC had previously developed methodology around a few of the waivers, there are some that we still need to investigate. This project was a good opportunity to explore the data and learn more about how these waivers come through on claims. More information about Long-Term Services and Support is available here.
5.) What did you learn while performing this analysis?
While doing the background research, we learned a lot about the barriers to care that Colorado’s aging population faces and how those barriers can be reflected in outcomes for the patients. Measures in this analysis that are particularly impacted by barriers to care include: high emergency department utilization rates, patients presenting with multiple chronic conditions, and readmissions within 30 days of discharge. Barriers to care can be many things such as finances, transportation, and lack of social/family support. Additionally, the lack of access to technology, low digital health literacy, and patient portals or apps with user experiences that don't consider accessiblity can disproportionately affect older adults. Those living in rural areas can be especially impacted by these factors.